Healthcare Provider Details

I. General information

NPI: 1700335635
Provider Name (Legal Business Name): KRISTINA LEE HUBER WHITE LCPC, RPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2016
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 MONTEREY WAY
LAWRENCE KS
66049-3530
US

IV. Provider business mailing address

1221 MONTEREY WAY
LAWRENCE KS
66049-3530
US

V. Phone/Fax

Practice location:
  • Phone: 605-359-6235
  • Fax:
Mailing address:
  • Phone: 605-359-6235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC7357
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: